Diarrhea
Frequent loose or watery stools are a common side effect of several chemotherapy drugs used to treat colorectal cancer, and it is critical to identify the more serious complicated diarrhea early and treat it aggressively. Before beginning chemotherapy, patients should understand their existing pattern of daily stools—number and consistency—to use as a baseline. People with ostomies should also note the consistency and amount of daily output.
- Uncomplicated diarrhea is mild or moderate with an increase of fewer than 7 stools a day. It can be conservatively managed with over-the-counter Imodium® (loperamide). The dose of Imodium for chemotherapy-induced diarrhea is different from that on box, so check with your doctor for how to use it. Usually, two pills (4mg) are taken initially with another 2 mg pill taken every four hours or after every loose stool until there has been no diarrhea for 12 hours.
- Changes in diet also help with diarrhea. Milk and milk products should be stopped. Frequent small meals and foods like bananas, rice, applesauce, toast, or plain pasta are recommended until diarrhea improves.
- Clear liquids—at least 8 to 10 glasses daily—are important to avoid dehydration. If nausea or vomiting keep you from drinking liquids, call your doctor or oncology nurse right away.
- If diarrhea doesn’t improve after 24 to 48 hours, gets worse, or other symptoms develop, it is very important to contact the doctor for additional evaluation and treatment.
- Symptoms of complicated diarrhea include 7 or more loose or watery stools a day, abdominal cramping, nausea and vomiting, fever, bleeding, or dehydration. Blood counts may change. Patients may feel weak or dizzy, especially when they stand up.
- Aggressive treatment includes a stronger drug called octretide, antibiotics, and intravenous fluids. Hospitalization may be required.
- Abdominal cramping is an early sign that diarrhea is complicated and needs more aggressive treatment. If you experience abdominal cramping, contact your doctor immediately.
Last Update: April 9, 2008
Medical Review
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